호스피스 시설의 유형별 공간구성에 관한 건축 계획적 연구

조광현,박재승 한국의료복지시설학회 2002 의료·복지 건축 Vol.8 No.1

Recently cancer, AIDS, chronic sickness have increased according to the elevation of socioeconomic level and fast change of lifestyle. The number of patients receiving terminal care increased fairly because the span of life is extended by development of medicinal technology. Also necessity of hospice and palliative care was risen according to the request of terminal patients that remove pain and keep calm life by interest about quality of life, However architectural plan and type specialization of facility which can correspond team's composition and supplied nursing program are not consisting. This study researches about care environment of hospice facility plan through investigation into terminal patient's special quality. The purpose of this study is to propose fundamental datas of hospice facility for architectural plan through comparative analysis of cases of domestic and outside facilities.

심장수술 2,450예와 심장이식

조광현,황윤호,이양행,류지윤 인제대학교 1999 仁濟醫學 Vol.20 No.1S

인제대학교 부산백병원에서는 1985년 10원 개심술이 처음 시행된 이후 1998년 말까지 2,450예의 개심및 비개심 심장수술이 이루어졌는데 이중 개심술이 2,290예, 비개심술은 160예 였다. 개심술 중 선천성이 1,697예(74.1%), 후천성이 573예(25.9%)였으며, 선천성 중에는 비청색증군이 1,548예(91.2%), 청색증군이 149예(8.8%)이었다. 후천성 중에는 심장판막질환이 471예(79.6%)로 가장 많았고, 관상동맥우회수술이 73예(12.1%), 대동맥류수술이 28예(4.7%), 심장종양절제술이 15예(2.5%) 및 심장이식수술이 2예, 기타 4예 등이었다. 특히 1993년부터 심장이식술을 위한 기초 및 동물실험 을 계속하다가 1997년 9월 말기심부전증환자에게 심장이식이 성공적으로 이루어져 개심술의 새로운 장을 열게 되었다. 술후 조기 사망은 선천성 비청색증군에서 30예(1.9%), 청색증군에서는 27예(16.7%), 후천성질환군에서는 26예(4.4%)였고, 전체 수술성공률은 96.5% 로 비교적 좋은 성적을 거두었다. From Sep. 1985 to Dec. 1998, 2,450 cases of heart operation including 2 cases of orthotopic heart transplantaion were performed in the Department of Cardiothoracic Surgery, Inje Universty, Pusan Paik Hospital The results of retrospective clinical review of them were obtained as follows. 1.Open heart surgery cases and non-open heart surgery cases were 2.290 and 160, respectively. Among the open heart cases, congenital cases and acquired cases were 1,697(74.1%) and 593 (25.9%), respectively. 2.Among the congenital cases, acyanotic cases and cyanotic cases were 1,548(91.2%) and 149(8.8%), respectively. The postoperative hospital mortality was 1.9% (30 cases) in the acynotic group and 16.6% (25 cases) in the cyanotic group. 3.Among the acquired cases, valvular heart disease, coronary artery disease, aortic aneurysm, cardiac tumor, heart transplantation and others were 471 (79.6%), 73(12.1%), 28(4.7%), 15(2.5%), 2(0.3%) and 4(0.7%) cases, respectively. 4.Prosthetic valve replacement (457 case, 97.0%) and valve reconstructive surgery(14 cases, 3.0%) were performed for the valvular diseases. Postoperative hospital mortality of valve surgery and coronary artery bypass surgery was 2.8% (13 cases) and 28.6% (6 cases), respectively. 5.28 cases of aortic aneurysm (ascending or arch aneurysm) were operated under cardiopulmonary bypass. The causes of aneurysm were annuloaortic ectasia(9), dissecting aortic aneurysm(16), and non-dissecting chronic aneurysm(8). The early postoperative hospital mortality was 8 cases(28.6%). 6.Two cases of heart transplantation were performed successfully using Shumway method .The total ischemic time of donor heart was 80 minutes and 50 minutes respectively. 7.Minimally invasive surgery (using lower sternal incision) was performed successfully in the cases of mitral and tricuspid valve diseases(10) and congenital septal defects (20). In conclusion, the over all postoperative hospital mortality was not so high as 3.5 %, whereas more proper management for congenital cyanotic group was seemed to be necessary.

Fallot 四徵症의 根治手術

曺洸鉉 인제대학교 1985 仁濟醫學 Vol.6 No.1

One of the most common of the more serious congenital malformations of the heart is the tetralogy of Fallet, which is said as the watershed between the simple and complex cardiac anomalies. And, therefore, all cardiac surgeons have been much interested in surgical approach of this anomaly. Although Stensen deserves credit for the first description in 1972 of what is new termed the tetralogy of Fallot, nevertheless it is Etienne-Louis Arthur Fallot (1888) of Marseille, France, whose name is characteristically attached to this congenital cardiac disorder. In the original description of this, Fallot stated, "This malformation consists of a true anatomopathological type represented by the following tetralogy: (1) stenosis of the pulmonary artery; (2) interventricular communication; (3) deviation of the origin of the aorta to the right; (4) hypertrophy, almost always concentric, of the right ventricle. Failure of obliteration of the foramen ovale mar ocassionally be added in a wholly accessory manner." Despite the fact that accurate clinical diagnosis could often be established after these contributions by fallot, nevertheless, many years passed before definitive treatment of this was initiated by Blalock and Taussig (1945) with the establishment of the subclavian artery to pulmonary artery anastomosis. Thereafter, several types of this kind of palliative operation were established by Potts (1946), Waterston (1962), Sellors (1948), Brock (1948) and Glenn (1954). In an imaginative and daring effort, in 1954, Lillehei using controlled crass-circulation, carried out the first intracardiac repair of this anomaly by closing the VSD and relieving the pulmonary stenosis under direct vision. The results of surgery for this have steadily improved over the years, thanks to important contributions of many surgeons. Nevertheless because of its protean physiologic and anatomic presentations, tetralogy of Fallot continues to offer challenges to cardiologists and cardiac surgeons. Auther wanted to study and summarize about the radical operation of this anomaly with literature review.

Nd:YAG 레이저 조사와 불화물 도포가 탈회법랑질의 재광화에 미치는 영향

조현,이광희,김대업 大韓小兒齒科學會 2004 大韓小兒齒科學會誌 Vol.31 No.3

Normal pulsed Nd:YAG 레이저 조사와 불소화합물이 산성음료수에 의해 탈회된 법랑질의 표면 미세경도에 미치는 재광화 효과를 평가하고자 한다. 법랑질 시편을 제작하여 50ml 플라스틱 시험관 5개에 코카콜라를 채운 후 30개의 소구치를 6개씩 나누어 넣고 탈회시켰다. 법랑질 표면에 6W 출혁하의 50mJ 에너지 밀도, 20Hz의 pulse rate로 레이저를 조사하였다. 레이저가 조사된 법랑질 표면에 각 군별로 여러 형태의 불소화합물을 처리한 후 탈회 전, 후의 미세경도 및 Diagnodent를 측정하였다. 동일한 방법으로 탈회된 법랑질에 레이저를 조사했을 때와 레이저가 조사된 법랑질 표면에 불소화합물을 처치한 후에 미세 경도 및 Diagnodent를 측정하였다. 법랑질 표면을 산성 음료에 탈회 후, 레이저 조사 후, 불소화합물 처치 후의 각각의 시편에 대하여, 주사전자현미경으로 1500배 확대하여 관찰하였다. 1. 산성 탈회된 법랑질 표면의 미세경도(VHN)가 레이저를 조사한 수와 불소 도포 후에 증가하였으나, 레이저 조사 후의 경도와 불소 도포 후의 경도간의 차이는 유의하지 않았다. 2. 초기 경도, 탈회 후 경도, 레이저 조사 후 경도, 불소 도포 후 경도에서 불소군 간의 차이는 모두 유의하지 않았고, 불소 용액 군과 불소 젤 군에서는 레이저 조사 후의 경도와 불소 도포 후의 경도 간에 유의한 차이가 없었으나, 불소 바니쉬군에서는 유의한 차이가 있었다. 3. Diagnodent 측정치의 변화에서 초기 점수, 탈회 후 점수, 레이저 조사 후의 점수와 불소 도포 후의 점수 간에는 유의한 차이가 있었고, 레이저 조사 후 점수와 불소 도포 후의 점수가 불소 도포 군 사이에서는 유의한 차이가 없었다. 4. 산성 음료수에 탈회된 법랑질 표면에의 Nd:YAG 레이저 조사는 재광화에 효과적이며, 불소화합물의 처치는 레이저의 효과를 증가시키는 부가적인 효과를 갖는다. 5. 주사 전자 현미경상에서 Nd:YAG 레이저가 조사된 법랑질 표면은 전체 표면이 법랑소주가 녹아내려 융합된 매끈한 바닥에 균열이 생기고 분화구가 퍼져 있는 양상을 보였으며, 불소 도포 후에는 균열과 분화구 형태는 뚜렷하지 않으며 탈회된 후의 표면에 가까운 양상을 보였다. The purpose of this in vitro study was to investigate the effects of Nd:YAG laser irradiation and fluorides on acid demineralized enamel. The materials were 30 freshly extracted permanent premolars with intact smooth enamel surfaces. They were demineralized with Coca-cola at 37℃ for 12 hours and then irradiated by Nd:YAG laser with 6W power, 50mJ/㎠ energy density, and 20Hz pulse repetition. After laser irradiation, teeth were treated by three kinds of fluorides; (1) 0.05% NaF fluoride solution (2) 1.23% APF gel and (3) 0.1%F fluoride varnish, microhardness(VHN) and Diagnodent scores were measured and the surfaces of each treated specimens were also observed with SEM under 1500 magnification. The results were as follows: 1. In the change of microhardness(VHN), it decreased to 34.68% from the initial micrhardness, increased to 78.37% after laser irradiation and increased to 82.62% after fluoride treatment, there were significant differences except when it was irradiated and treated with fluoride(P<0.05). 2. In the change of Diagnodent scores, it was decreased to 28.08% from the initial scores after demineralization, and then increased to 59.81% after laser irradiation, and increased to 82.17% after fluoride treatment. Scores were different significantly between the scores of initial, demineralization, laser irradiation and fluoride treatment (P<0.05). All the scores were not different significantly between fluoride types. 3. SEM observation showed that the lased enamel surfaces after demineralization were thermally degenerated and showed molten lava-like appearance and crater with cracks and many microholes.

대기 현상에 대한 초등학생의 선개념 및 오개념 분석

조현희,김광명 춘천교육대학교 과학교육연구소 2001 과학교육연구 Vol.24 No.-

Trirutile type 고체촉매를 이용한 olefin의 에폭시화 반응에 관한 연구

조영범,안광현 慶熙大學校 材料科學技術硏究所 2000 材料科學技術硏究論集 Vol.13 No.-

과산화수소를 이용한 알켄의 산화 반응에서 trirutile type 고체 산화물이 효과적으로 촉매 역할하는 것을 관찰할 수 있었다. 특별히 HNbMoO_(6), LiNbMoO_(6) 및 HNbWO_(6)등이 좋은 촉매효과를 보여주었다.

심실중격결손증-치험 1예-

조광현,우종수,황윤호,이양행,박철호,김종성,김철호,이경순,조영일,박태인 인제대학교 1985 仁濟醫學 Vol.6 No.4

A successful treatment of infants and children with congenital heart defects depends upon several factors: diagnosis must be accurate, the operative technique, including techniques of perfusion and myocardial preservation, must be suited to the needs of patients and intensive cares, including accurate anesthesia, must be applied through all stages of investigation and treatment, i.e. before, during and after the operation. Recently we performed a open heart surgery successfully for a six-years old girl who had suffered from frequent upper respiratory tract infection and mild to moderate exertional dyspnea with congenital heart defects (ventricular septal defect, Kirklin type II, with patent foramen ovale). The operation and postoperative course were very smooth. And now we report this with review of literatures.

Helicobacter pylori와 대장균의 Shuttle Vector 개발

조명제,이우곤,이상룡,김경희,안영숙,김성희,김현주,류복덕,최여정,윤영혜,백승철,전영석,이광호 경상대학교 유전공학연구소 1997 遺傳工學硏究所報 Vol.16 No.-

In this study, a vehicle vector using cryptic plasmids was constructed for gene transfer in Helicobacter pylori. pHP51(3.9 kb) and pHP489(1.2 kb) were selected for constructing vectors from cryptic plasmid of H. pylori isolates in Korea. The HindⅢ-digestedDNA fragment(1.2kb) of pHP489 and 1.6kb DNA fragment of pHP51 were ligated with a kanamycin resistance gene(aph3'-Ⅲ) from C. jejuni to produce the recombinant plasmids pHP489K and pHP51K, respectively. Transformation frequency of pHP51K by electroporation was low. But pHP489K could be effectively transformed into various H. pylori strains. In order to design an intermdiate vehicle vector for gene transfer into H. pylori, pBlueHP489K was prepared by recloning pHP489K DNA into pBluescript and pTZ19R vector. This vector permitted the DNA fragment containing pHP489 sequence, aph3'-Ⅲ, and cloned DNA to be cut and self-ligated in the SacⅠ site after cloning. ureA and ureB gene were inserted into pBlueHP489K, resulting in pBlueHP489K/AB. The DNA fragment containing pHP489, kanamycin resistance gene(aph3'-Ⅲ), and urease structural gene was cut away from pBlueHP489K/AB and self-ligated to generate pBlueHP489K/AB. pBlueHP489K/AB made urease-negative H. pylori strains restore their urease activity. By this experiment, pBlueHP489K was confirmed to be the vehicle system for transferring H. pylori genes.

원예작물의 염류장애 원인과 대책을 위한 생리, 생화학적 연구 2. 토마토 뿌리조직 H+ 펌프 활성 및 Thapsigargin 저해효과

조광현,사공정,김영기 충북대학교 한국과학재단 지정 첨단원예기술개발 연구센터 1997 연구보고서 Vol.2 No.-

Thapsigargin은 동물조직 SR/ER-type Ca²+-ATPase에 특이성이 높은 선택적 저해제로서 토마토 뿌리조직으로부터 분리한 마이크로솜에 Ca²+-ATPase의 존재를 확인하기 위하여 사용되었다. 원형질막과 액포막에 위치하는 H+-ATPase들의 활성은 각각의 선택적 저해제인 vanadate와 NO₃를 이용하여 평가하였고, 이들의 활성은 각각 마이크로솜 ATPase 총활성의 ∼26%, ∼36%로 나타났다. 이들 두 가지 저해제 효과는 additive하게 나타났으며, 전체활성의 약 50∼70%를 저해함을 확인하였다. 마이크로솜 ATPase활성에 대한 thapsigargin의 저해효과에서 10 μM thapsigargin은 총활성의 30%를 저해하였으며, 저해효과는 농도 의존적으로 나타났다. Thapsigargin에 의한 활성저해 기작을 조사하기 위하여 H+-ATPase의 선택적 저해제들을 사용하였다. 액포막의 H+-ATPase 활성에 대한 thapsigargin의 효과를 조사하기 위한 NO₃의 dose-response 실험에서, thapsigargin은 NO₃에 의해 저해되는 ATPase활성을 경쟁적으로 감소시켰다. 반면, vanadate의 농도를 10 nM∼2mM로 증가시켜 원형질막의 H+-ATPase 활성을 저해시킨 조건에서는 thapsigargin에 의하여 저해되는 활성이 온전히 나타나 vanadate의 저해효과와는 무관한 결과를 얻었다. 이러한 결과는 액포막 H+-ATPase의 활성이 thapsigargin에 의해 저해된다는 것을 의미한다. 저자들은 액포막 H+-ATPase의 활성이 Ca²+에 의하여 저해됨을 이미 보고하였다 (Cho et al., 1998). Thapsigargin에 의하여 저해되는 마이크로솜 ATPase활성은 반응용액의 Ca²+농도가 증가할수록 감소하였으며, 이것은 thapsigargin이 액포막 H+-ATPase 활성을 저해한다는 가능성을 더욱 지지하였다. 이상의 결과는 토마토 뿌리조직의 마이크로솜 ATPase중 액포막의 H+-ATPase 활성이 thapsigargin에 의해서 저해되는 것을 보여주며, 액포막 H+-ATPase와 ER-type Ca²+-ATPase와의 구조적, 기능적 연관성이 있을 가능성을 제안한다. The effect of thapsigargin, a SR/ER-type Ca²+-ATPase inhibitor, was investigated to determine the presence of thapsigargin-sensitive Ca²+-ATPases in the microsomes of tomato roots. The activities of plasma membrane H+-APTase and vacuolar H+-ATPase were evaluated to ∼26% and ∼36% of total microsomal ATPase activity by using their specific inhibitors, vanadate and NO₃, respectively. The inhibitory effects of vanadate and NO₃- were additive and the simultaneous additions of these two inhibitors decreased the total activity up to 50∼70%. Thapsigargin (10μM) inhibited the microsomal ATPase activity by ∼30% and the thapsigargin-induced inhibition was appeared to be dose-dependent. In order to understand the molecular mechanism of thapsigargin-induced inhibition, the effects of specific H+-ATPase inhibitors were tested and compared to the effect of thapsigargin. The NO₃-induced inhibition was decreased by simultaneous treatment of thapsigargin. In dose-response experiments of vanadate and NO₃-, thapsigargin only blocked the NO₃-induced inhibition, while the effects of vanadate and thapsigargin were independent at the whole range of vanadate concentration (10 nM∼2 mM). Meanwhile, the thapsigargin-induced inhibition was decreased by increasing Ca²+ concentration. Since we have shown that Ca²+ blocks the activity of vacuolar H+-ATPase, these results together suggest that thapsigargin inhibits the NO₃-sensitive vacuolar H+-ATPase but not the vanadate-sensitive plasma membrane H+-ATPase. Our results also suggest that there is structural and functional relations between vacuolar H+-ATPase and SR/ER-type Ca²+-ATPase.

瓦松의 알콜 抽出物이 心筋 및 腸筋收縮에 미치는 影響

曺石鉉,金光鎭 충남대학교 의과대학 지역사회의학연구소 1987 충남의대잡지 Vol.14 No.1

Orostachys malacophyllus F. is a kind of ,Chinese medicine to grow on the tiled roof of the house or on the rock of the mountain. The chemical compositions and actions have not been reported, but, sometimes, it was used as a folk remedy for the treatment of cancerous diseases. This study was attempted to investigate the effects of water fraction separated from alcohol extract of Orostachys malacophyllus F. on the contractilities of cardiac and intestinal muscles comparing with those of the water extract. The muscles used for this study were the ventricular muscle of turtle and the intestinal muscle of mouse, and their contractilities were represented as a change of the muscle tension detected by myograph. The results were summarized as follows: 1. The water fraction decreased the contractility of ventricular muscle, and increased the intestinal contractility. But the water extract was observed the opposite effects on the contractility of each muscle. 2. Sympathetic or parasympathetic blocker and alpha-or beta-blocker had no effect on the decreased or increased contractility of each muscle. 3. Calcium antagonist(verapamil) inhibited significantly the contractility in the case of the water fraction to the intestinal muscle and the water extract to the ventricular muscle. From the above results, it was suggested that the action of water fraction or the water extact affected to calcium transport: release into the sarcoplasmic fluid or active influx into the sarcoplasmic reticulum in the case of the cardiac muscle, and release from ECF or cisternae of reticulum into the muscle cell in the smooth muscle.